title: Sleep duration and coronary heart disease mortality among Chinese adults in Singapore: a population-based cohort study.
abstract: While some studies have found a positive association between both short and long sleep durations and cardiovascular disease (CVD), others have found an association only with a long or short sleep duration. In addition, there are limited data from non-Western populations on this topic. The authors examined the association between sleep duration and coronary heart disease (CHD) mortality among Chinese adults in Singapore (1993-2006), performing a prospective cohort study among 58,044 participants aged > or =45 years (55.9% women) without preexisting CVD. The main outcome of interest was CHD mortality (n = 1,416). The authors found both short and long sleep durations to be positively associated with CHD mortality, independent of smoking, alcohol intake, and body mass index. Compared with persons with a sleep duration of 7 hours (referent), the multivariable relative risk of CHD mortality for a sleep duration of < or =5 hours was 1.57 (95% confidence interval: 1.32, 1.88); for a sleep duration of > or =9 hours, it was 1.79 (95% confidence interval: 1.48, 2.17). This association persisted in subgroup analyses by sex and body mass index. In a population-based cohort of Chinese adults from Singapore, sleep durations of < or =5 hours and > or =9 hours (versus 7 hours) were modestly associated with CHD mortality. These results suggest that sleep duration may be an important marker for CVD.
authors.affiliation: Department of Community Medicine, West Virginia University School of Medicine, 1 Medical Center Drive, PO Box 9190, Morgantown, WV 26506-9190, USA. ashankar@hsc.wvu.edu
authors.forename: Anoop
authors.initials: A
authors.lastname: Shankar
authors.forename: Woon-Puay
authors.initials: WP
authors.lastname: Koh
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Yuan
authors.forename: Hin-Peng
authors.initials: HP
authors.lastname: Lee
authors.forename: Mimi C
authors.initials: MC
authors.lastname: Yu
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People / Q000208:ethnology*; D003327:Coronary Disease / Q000401:mortality* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012846:Singapore / Q000453:epidemiology; D012890:Sleep / Q000502:physiology*; D015996:Survival Rate / Q000639:trends